The personality profile and alexithymic syndrome in primary headache: a Rorschach study

The aim our work was to study the personality profile and alexithymic syndrome (based on the analysis of seven specific markers) of primary headache patients through the Rorschach test. 240 headache patients all drawn from Headache Centre of Neurological Science Institute of Neurological Science Institute of the Second University of Naples, in the period 1995–1998, were the sample studied. 30 (6 women) were affected by cluster headache; 32 (22 women) by migraine with aura; 66 (32 women) by tension-type headache. 60 subjects (34 women) formed the control group. There was no sigificant difference (p>0.05) between groups for age and education, and to all subjects the tests were administered in interval periods by two different examinators. All patients with organic illness or known psychatric illness were excluded by the present study. The results obtained have been transformed into numeric terms and then into data to be utilized for frequency index, description and statistical analysis (t test). The results show an uniformity of alexithymic characteristics in various headache groups, with a short margin of variability. Besides, the headache patients showed a marked restriction in fantasy, with concrete and stereo-typic thought, poor adaptive emotional responsiveness, and lack of relational mechanisms and adaptability to millieu. The analysis of the results supports the following observations: (1) despite of little differences in some specific parameters or personality sectors, headache subjects appear to be quite homogeneous in perceptual and processing style, affectivity and adaptive resources; (2) these data are similar to what has been found in psychosomatic illness; (3) independently of neuropsychological, neuroanatomical and functional substratum of these behaviours, a psychotherapeutic approach to headache can be useful in addition to common pharmacological therapy; and (4) data expressed by the analysis of Rorschach parameters certainly exclude an analytical-type psychotherapeutic approach, on the contrary, behavioural approach techniques appear to be more useful in that they facilitate and improve experience control and self-regulation.